Use Of Pads Research Articles

Accuracy of a Smart Diaper System for Nursing Home Residents for Automatically Detecting Voided Volume: Instrument Validation Study.

Diapers are commonly used by older patients with urination disorders. A smart diaper system (SDS) may be able to estimate the weight of urine comparably to conventional measurements made by weighing diapers. The aim of the current research is to determine the degree of accuracy of an SDS technology specifically designed for the management of urination routines and the use of incontinence pads in older adults. From January to December 2022, 97 older patients with at least 1 chronic disease from 3 nursing homes were included. In this study, the SDS was used for 1 month per patient after obtaining their consent; all patients originally used traditional diapers in the nursing home. The index test measured the change in electrical resistance of the SDS and the reference test measured the change in actual urine weight. When measuring the actual urine weight, the degree of absorption was directly confirmed with the naked eye because the expression value varied according to pressure changes caused by the user's movement or position. The Pearson correlation was used to determine the correlation between the 2 test methods, the intraclass correlation coefficient (ICC) was used to check the degree of agreement between the evaluators, and the Bland-Altman test was used to confirm whether there was a significant difference between the 2 test methods. The average age of the 97 participants was 86.48 (SD 6.26) years, with 10 men and 87 women. There were 73 patients (75%) with hypertension, 86 patients (88%) with dementia, and 86 patients (88%) with 2 or more comorbidities, accounting for the majority. The Pearson correlation coefficient and ICC were 0.971 and 0.985 (P<.001). In the Bland-Altman figure, the difference in the mean between the 2 tests was evenly scattered without showing a specific pattern, indicating that the SDS and actual urine weight were very consistent. The difference between the mean of the 2 tests was -0.045 of the standardized mean difference, and all measurements were located within the 95% CI, so this confirms that the 2 test methods are equivalent. Our study showed a fairly high correlation coefficient and ICC for all patient groups, which reveals that the 2 tests were very consistent and that the SDS can replace traditional diapers, even in a real clinical setting. This study shows the possibility that heath care professionals could be alerted by the SDS to the need for pad replacement due to incontinence, thus avoiding the development of dermatological complications.

What Is the Optimal Strategy for Pouch Salvage at Time of Redo Ileal-Pouch Anal Anastomosis? Pouch Repair with Reanastomosis vs Pouch Excision with Neopouch.

The long-term risk of pouch failure after restorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) range from 5% to 15%. Salvage surgery for failing IPAA may be achieved by disconnecting the IPAA and either repairing and reusing the existing pouch (REP) or constructing a neopouch (NEO). We aimed to evaluate whether there are differences in long-term functional pouch survival and functional outcomes between the REP group and the NEO group. We hypothesized that patients undergoing REP have higher long-term pouch survival rates compared with patients who require NEO pouch construction. Our prospectively maintained Pouch Registry was queried for patients who underwent a pouch salvage surgery with either pouch REP or NEO from 1988 to 2020. Patients who underwent pouch repair without disconnection from the anus were excluded. The primary endpoint was long-term pouch survival after redo pouch surgery. Secondary outcomes were patient-reported quality of life and pouch function. Of 653 patients undergoing redo IPAA, 462 met inclusion criteria of transabdominal redo surgery with pouch reconnection: 243 (52.6%) had REP and 219 (47.4%) had NEO. Median age was 39 years and 59% were women. Median time between index and redo IPAA was 34 months for REP vs 54 months for NEO (p = 0.002). The 5-year pouch survival after redo IPAA was similar between REP (79.5%) and NEO (76.8%) groups (p = 0.4). Fewer patients in the REP group reported nighttime pad use (51.4% vs 68.2%, p = 0.04). Pouch survival and functional outcomes after salvage surgery for failing ileoanal pouch was similar regardless of pouch salvage procedure. When performing redo pouch surgery, surgeons should not hesitate to construct a new pouch if indicated.

Exploring the Socio-personal Factors Associated with the Prevalence of Symptoms of Reproductive Tract Infections among Sexually Active Married Women in Ernakulam District of Kerala, India

Abstract Background: Reproductive Tract Infections (RTIs)/Sexually Transmitted Infections (STIs) are the main cause of maternal mortality and morbidity in India. The prevalence of the symptoms of RTIs was found to be very high in community-based studies. However only a few studies have explored the factors associated with it. This study aims to determine the socio-personal factors associated with the prevalence of symptoms of RTIs among sexually active married women in Ernakulam district of Kerala. Material and Methods: The study adopted a cross-sectional approach and was conducted among 640 married women in the reproductive age group. Results: The prevalence of the symptoms of RTIs was found to be 56.9% and about 60.16% of them had experienced multiple symptoms. Multivariate analysis showed that those women living in the urban areas (OR: 0.49, 95% CI: 0.334, 0.719), having no previous history of obstetric/gynecological risk factors (OR: 1.89, 95% CI: 1.119, 3.19) and using both clothes and sanitary pads interchangeably during menstruation (OR: 0.46, 95% CI: 0.282, 0.734) were found to be at less risk of contracting RTIs. Conclusion: The use of sanitary pads along with cloth pads can be enhanced rather than only using reusable cloths during menstruation. Also, efforts to improve the reproductive health of the women and reduce the obstetric/gynaecological risk factors should be devised to curtail the peak of RTIs.

Postprostatectomy Radiotherapy Timing and Long-Term Health-Related Quality of Life

The association between radiotherapy (RT) timing after radical prostatectomy and long-term patient-reported health-related quality of life (HRQOL) in men with prostate cancer is unknown. To measure long-term HRQOL in men with prostate cancer up to 15 years after prostatectomy with or without RT and examine whether early vs late postprostatectomy RT is associated with differences in sexual, urinary, and bowel HRQOL. A prospective, multicenter, longitudinal cohort analysis using HRQOL data from the PROST-QA (2003-2006) and RP2 consortium (2010-2013) studies was conducted. Men with localized prostate cancer undergoing radical prostatectomy were included. Data were analyzed between May 8, 2023, and March 1, 2024. The study was conducted in 12 high-volume academic medical centers in the US. Men were stratified based on receipt and timing of postprostatectomy RT: prostatectomy only, early RT (<12 months), and late RT (≥12 months). Longitudinal sexual, incontinence, urinary irritation, bowel, and hormonal/vitality HRQOL were measured via the Expanded Prostate Cancer Index Composite at baseline; months 2, 6, and 12; and annually thereafter. Treatment groups were compared using multivariable linear mixed-effects models of change in longitudinal domain scores. Pad use for incontinence was measured longitudinally among men receiving postprostatectomy RT. A total of 1203 men were included in the study: prostatectomy only (n = 1082), early RT (n = 57), and late RT (n = 64). Median age for the entire cohort was 60.5 (range, 38.8-79.7) years, and 1075 men (92.0%) were White. Median follow-up was 85.6 (IQR, 35.8-117.2) months. Compared with men receiving prostatectomy alone, those receiving postprostatectomy RT had significantly greater decreases in sexual, incontinence, and urinary irritation HRQOL. However, timing of postprostatectomy RT, specifically early vs late, was not associated with a long-term decrease in any HRQOL domain. There was evidence of improved recovery of sexual, continence, and urinary irritation scores among men receiving early RT compared with those receiving late RT after prostatectomy. Before the start of postprostatectomy RT, 39.3% of men in the early RT cohort and 73.4% of men in the late RT cohort were pad-free. By the sixth visit post-RT, 67.4% in the early RT cohort and 47.6% in the late RT cohort were pad-free. In this multicenter, prospective analysis, postprostatectomy RT appeared to be negatively associated with long-term HRQOL across all domains. However, receipt of early vs late postprostatectomy RT may result in similar long-term HRQOL outcomes.

Characteristics of oral mucosal pressure injuries in children with orotracheal intubation in intensive care units: An observational study.

Tracheal intubation can be used for ventilation to ensure an unobstructed respiratory tract, and it is the most common respiratory support technique used in paediatric intensive care unit (PICU) patients. Orotracheal intubation is usually the preferred method of tracheal intubation. However, it can cause stress-related damage to the oral mucosa. Identifying the factors that cause oral mucosal pressure injury (OMPI) can prevent its occurrence in children with oral endotracheal intubation. To examine the characteristics of OMPI in children who underwent orotracheal intubation in the PICU and to assess their influencing factors. An observational, prospective study. Data were gathered from the PICU of a tertiary hospital in China between January 2023 and October 2023. The patient data were obtained from the 'General Information Questionnaire', 'Paediatric Critical Illness Score', 'STRONGkids Scale' and 'OMPI Staging and Assessment Tools'. Data analysis was subsequently performed using univariate and logistic regression analyses. A total of 187 children who underwent orotracheal intubation were analysed. During the observation period, 44.92% (n = 84) of the children developed OMPI. It comprised 63.10% (n = 53) of stage I injuries, 33.33% (n = 28) of stage II injuries and 3.57% (n = 3) of stage III injuries. The common injury sites were the lower jaw (48.81%), upper jaw (29.76%), tongue (20.24%) and joints (10.71%). The logistic regression analysis results revealed that high critical illness (OR = 0.835, 95% CI: 0.726-0.961), long intubation time (OR = 1.043, 95% CI: 1.021-1.067), prone ventilation (OR = 6.708, 95% CI: 1.421-31.670), hypothermia (OR = 5.831, 95% CI: 1.208-28.149), use of dental pads (OR = 5.520, 95% CI: 1.150-26.487) and low albumin levels (OR = 6.238, 95% CI: 1.285-30.281) were the main contributing factors for OMPI in children with orotracheal intubation (p < .05). The occurrence of OMPI in children who underwent orotracheal intubation in the PICU was notable and was predominantly observed in stages I and II. Consequently, clinical nursing personnel should proactively recognize risk factors and administer timely interventions to mitigate the occurrence of OMPI in such children. The incidence of OMPI in children who underwent orotracheal intubation was relatively high. Nurses and doctors should closely monitor the risk factors for orotracheal intubation in children to prevent the occurrence of OMPI.

Impact of oral antithrombotic agents on urinary continence recovery following robot-assisted radical prostatectomy: a retrospective cohort study

BackgroundRobot-assisted radical prostatectomy (RARP) is a preferred minimally invasive surgical treatment for prostate cancer. The number of elderly patients and those with cardiovascular and/or cerebrovascular issues undergoing surgery is increasing, and many of them are taking antithrombotic (AT) agents. However, the effect of AT agents on postoperative urinary recovery has not been adequately studied. In this study, we analyzed the differences in the postoperative recovery of urinary continence and oncological outcomes in patients undergoing RARP for localized prostate cancer between AT agent adherents and non-adherents.MethodsA total of 394 patients who underwent conventional anterior RARP between February 2015 and February 2021 were categorized into two groups: those taking oral AT agents (AT group) and the control group. Urinary continence recovery, complications, and oncological outcomes were compared between the groups. A Cox proportional hazards analysis was performed to identify clinical factors that affect urinary continence recovery.ResultsThe background data and bleeding complications did not differ significantly between the groups. The recovery of continence was significantly poorer in the AT group in terms of complete pad free (HR: 0.53 [95% CI: 0.39–0.71]) and use of ≤ 1 safety pad (HR: 0.74 [95% CI: 0.59–0.94]). The rate of anastomotic leakage on cystography was significantly higher in the AT group (20.9% vs. 6.7%). A univariate analysis revealed that taking antithrombotic agents, higher prostate-specific antigen levels, and a more advanced clinical stage were associated with a poor urinary continence recovery; a multivariate analysis showed that taking AT agents was an independent factor negatively associated with urinary continence recovery. There was no significant difference between the groups in the positive surgical margin rate (19.0% vs. 23.8%) or the biochemical-recurrence-free rate.ConclusionTaking oral AT agents may be associated with poor urinary continence recovery after RARP.

Telehealth exercise for continence after gynaecological cancer treatment (TELE-CONNECT): a protocol for a co-designed pragmatic randomised controlled trial

BackgroundUrinary incontinence (UI) is the most prevalent pelvic floor disorder following treatment for gynaecological cancer with a distressing impact on quality-of-life in survivors. Physiotherapist-supervised pelvic floor muscle (PFM) training is recommended as the first-line intervention for UI in community-dwelling women. However, it is not known if this intervention is effective in women following treatment for gynaecological cancer, nor whether PFM training can be delivered entirely remotely. The primary aim of this study is to investigate if a telehealth-delivered PFM training program incorporating a novel biofeedback device reduces UI compared with usual care, following gynaecological cancer.MethodsThis is a pragmatic, two-arm parallel-group, stratified superiority randomised controlled trial recruiting 72 participants (ACTRN12622000580774). Recruitment sites include gynaecology-oncology outpatient clinics, supplemented by advertisements through community foundations/social media/care groups. Participants must have completed primary cancer treatment at least 6 months prior or adjuvant therapy at least 3 months prior, for Stage I, II or III uterine, cervical, fallopian tube, primary peritoneal or ovarian cancer or borderline ovarian tumour, and have UI occurring at least weekly. Participants randomised to the usual care group will receive bladder and bowel advice handouts and one audio telehealth physiotherapist consultation to answer any queries about the handouts. Participants randomised to the intervention group will receive the same handouts plus eight video telehealth physiotherapist consultations for PFM training with a biofeedback device (femfit®), alongside a home-based program over 16 weeks. The primary outcome measure is a patient-reported outcome of UI frequency, amount and interference with everyday life (measured using the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form), immediately post-intervention compared with baseline. Secondary outcomes include quality-of-life measures, bother of pelvic floor symptoms, leakage episodes, use of continence pads and global impression of change. We will also investigate if the intervention improves intra-vaginal resting and squeeze pressure in women in the intervention arm, using data from the biofeedback device.DiscussionIf clinical effectiveness of telehealth-delivered physiotherapist-supervised PFM training, supplemented with home biofeedback is shown, this will allow this therapy to enter pathways of care, and provide an evidence-based option for treatment of post-cancer UI not currently available.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR), ID 12622000580774. Registered 20 April 2022.

Management of Bladder and Bowel Dysfunction in Patients with Multiple Sclerosis

Bladder and bowel dysfunctions are common in patients with multiple sclerosis (MS) and negatively affect their quality of life. Bladder dysfunction, which is prevalent in people with MS (PwMS), can impact almost all patients within 10 years after diagnosis. Conservative, medical, and electrical stimulation approaches are used in the treatment of these problems. Bladder dysfunction in patients with multiple sclerosis can lead to issues such as fluid intake restriction, withdrawal from work life, inability to socialize, and the need for constant use of pads, resulting in a depressive lifestyle. Bowel dysfunction in patients with multiple sclerosis can manifest as fecal incontinence and/or constipation, which can also negatively affect patients' quality of life. Various approaches are utilized in the management of bladder and bowel dysfunction. Multiple sclerosis nurses play a key role in the multidisciplinary team for the diagnosis, treatment, and follow-up of patients' bladder and bowel symptoms. Effective nursing care, education, and counseling in the management of these symptoms enhance the comfort of patients with multiple sclerosis. In this review, the bladder and bowel dysfunctions experienced by patients with multiple sclerosis and the management of these problems are discussed in line with current knowledge.

Efficient Highlighting of Visual Targets in Complex Natural Scenes

Guided visual search is a common theme in HF applications. In this project we use large-scale databases of wildlife camera-trap imagery as a testbed for optimization of target highlighting. MegaDetector, a generic animal detection deep machine learning model, provides bounding boxes for potential targets within an image. In some cases, human observers are necessary to confirm or further classify the detections. Outlining the bounding box can direct human attention to the target AOI to improve observers’ classification speed and accuracy. However, this outline introduces visual clutter and crowding at the AOI boundary. In a first empirical study we investigate the use of padding to mitigate the effects of local clutter and compared different methods of visual highlighting (colored outline vs. blur outside of AOI). We found support for using padding to improve performance when animals were hard to see. Both colored outlines and blur were effective at directing observers’ attention.

Prevalence and risk factors for overactive bladder symptoms in patients with artificial urinary sphincter

To demonstrate the prevalence and risk factors for overactive bladder symptoms associated with artificial urinary sphincter implantation, we investigated the patients who underwent primary artificial urinary sphincter implantation with severe urinary stress incontinence. Forty-eight patients who completely answered the questionnaires of the overactive bladder symptom score before surgery were included. Patient characteristics, urinary status at pre and 1, 3, 6, and 12 months post-device activation, and predictive factors for overactive bladder symptoms were examined. Sixty percent of the patients had preoperative overactive bladder symptoms. Until 12 months after device activation, 35–40% of all patients had overactive bladder symptoms. The rate of persistent and de novo postoperative overactive bladder symptoms was 44.8% and 26.3%, respectively. Daily pad use was not different between patients w/wo overactive bladder symptoms. The only risk factor for postoperative overactive bladder symptoms was a max cystometoric capacity < 200 mL measured by a preoperative urodynamic study. Attention must be given to both persistent and de novo overactive bladder symptoms associated with artificial urinary sphincter implantation for patients with stress incontinence. Counsel should equally be provided for preoperative overactive bladder symptoms, especially in cases with a cystometric capacity < 200 mL.

Adverse Health Outcomes 3 Years after Radical Prostatectomy Compared with Men in the General Population: A Study from the Cancer Registry of Norway

IntroductionStudies about adverse health outcomes (AHOs) after radical prostatectomy (RP) in population-based contemporary prostate cancer (PCa) patients are limited, as well as knowledge about corresponding data from age-similar men from the general population (Norms). We compared selected AHOs (pad use, intercourse inability), related problems (bother) and quality of life (QoL) between PCa patients and Norms. Patients and methodsThe Cancer Registry of Norway (CRN) provided data on PCa patients diagnosed in 2017-2019 and treated with RP who completed the EPIC-26 and EORTC-QLQ-C30 questionnaires 24-48 months after surgery (n = 1501). The CRN also established a group of Norms (n = 1894). Dichotomized EPIC-26 outcomes: daily use of ≥1 pad (Item#3), quality of erections (Item#9) and related bother (Item#4a/#12). EORTC-QLQ-C30: quality of life (Item#30). Multivariable logistic regressions explored associations between selected covariates and outcomes. ResultsIn total, 41% of the patients and 5% in Norms reported pad use, the comparable figures for intercourse inability being 84% (Patients) and 48% (Norms). Among pad users, 24% of the patients and 25% of the Norms described bother. 52% of patients and 35% Norms with intercourse inability. Only bilateral nerve-sparing surgery (NSS) significantly reduced the risk of pad use and intercourse inability. Compared to Norms, PCa patients were associated with pad use, intercourse inability, related bother, and good/ fair QoL. ConclusionIn these population-based cohorts, 2 in 5 patients used pads 3 years after RP, compared to 1 in 20 Norms. Intercourse inability was reported by 4 of 5 patients compared to 1 of 2 Norms. PCa patients were associated with good/ fair QoL. Bilateral NSS significantly reduced the risk of AHOs, highlighting the importance of this approach. Function and bother are different dimensions of urinary and sexual AHOs and must be reported separately. The findings from this study should be considered when counselling patients before RP.

Martius Labial Fat Pad Use in the Treatment of Complications Associated With Prior Surgery for Urinary Incontinence or Pelvic Organ Prolapse

ObjectiveTo evaluate the outcomes of Martius Labial Fat Pad (MLFP) in the treatment of complications related to surgery for urinary incontinence (UI) and/or pelvic organ prolapse (POP) and to assess the influence of mesh presence. MethodsFollowing institutional review board approval (n° STU 2023 1280), a review of all women who underwent a MLFP procedure at our tertiary center after UI and/or POP repair was performed by an independent investigator. The primary outcome was the rate of post-operative complications classified according to the Clavien-Dindo classification. Secondary outcomes were based on indications and functional results. A subgroup analysis was performed according to the type of prior repair: mesh or native tissue repair. ResultsFrom 2006-2022, 26 patients underwent a MLFP procedure, with a median follow-up duration of 30 (12-67.5) months. Bladder outlet obstruction and fistulae were the two most frequent indications. Post-operative complications occurred in 15 patients (58%): grade I in 6 (43%), grade 2 in 3 (21%), grade 3b in 4 (29%) and grade 4b in 1 (7%). Four of the grade ≥ 3 complications occurred in the mesh group. Median operative time was longer in the mesh group: 200 minutes (177.5-229.5) versus 146 minutes (128-190) (p=0.03) and the success rate was lower: 61% versus 85% (p=0.06). Overall, surgery was successful in 19 patients (73.8%). ConclusionMFLP is a reliable flap in specialized indications after UI and/or POP repair procedures with a higher risk of major complications and a lower success rate in women previously operated with mesh.

Positioning in pelvic robotic surgery and its repercussions on patient safety

Objectives: To describe the positions used in robotic pelvic surgery, observe the impact of these positions on patient safety and evaluate precautions for the patient's surgical positioning during the intraoperative period. Methods: A Systematic Literature Review (RSL) was carried out over the last 5 years. Results: 184 articles were located, of which 13 were selected according to PRISMA recommendations. Result: It was found that the main type of positioning used in robotic surgeries of the pelvic region is the trendelenburg associated with the lithotomy position, in addition to the pneumopritoneus. The main complications are: bradycardia, thromboembolisms, increased ocular, intra-abdominal and intra-thoracic pressure, neuropraxia, compartment syndrome, increased ICP, facial edema, injuries to pressure points. Prevention measures include the use of special anti-skid padding and mattresses, buttock padding, adequate positioning of the limbs. The use of fastening straps is recommended to avoid the risk of slips and falls and repositioning to the supine position for 10 minutes every 3 hours.

A Modified Lateral Seminal Vesicle Approach Preserving the Bladder Neck in Laparoscopic Radical Prostatectomy Improves Urinary Continence Recovery.

The purpose of this study was to investigate the effect of laparoscopic lateral seminal vesicle approach to preserve the bladder neck during laparoscopic radical prostatectomy. Between September 2020 and December 2022, we retrospectively analyzed patients with T1-T3b stage prostate cancer treated at our institution using the laparoscopic lateral seminal vesicle approach. We recorded the bladder neck preservation success rate, cystourethral anastomosis time, urinary catheter extraction time, length of hospital stay, and urinary control scores, including urine pad use, at 1 week, 1 month, and 3 months post-catheter removal. Adverse events included rectal injury, bladder injury, ureteral injury and positive surgical margins. There were 56 patients (mean age 70 ± 5.8 years) The success rate of bladder neck preservation was 100%. The median cystourethral anastomosis time was 11 (9-14) minutes. The median postoperative hospital stay was 10 (9-11) days. The urinary continence rate was 83.9% (47/56) in 1 week, 89.3% (50/56) in 1 month and 98.2% (55/56) in 3 months. One patient developed adhesions caused by invasion of both seminal vesicles, which damaged the rectal wall. The laparoscopic lateral seminal vesicle approach can preserve the bladder neck completely during laparoscopic radical prostatectomy, improving postoperative urinary continence, with a high rate of immediate urinary continence, and significantly improving patients' quality of life.

Comparison of the infrapatellar and subcutaneous adipose tissue biopsy material as a source of mesenchymal stromal cells for regenerative medicine in traumatology

Objective. The use of infrapatellar fat pad (IPFP) as the source of mesenchymal stem cells (MSCs), show an age-independent proliferation and differentiation potential. In addition, the pronounced chondrogenic potential of IPFP-ASCs makes them promising candidates for research for use in other methodsof regenerative therapy. Methods. A direct immunohistochemical study was carried out in serial paraffin sections of the biopsy material of Hoffa`s fat pad and subcutaneus fat tissue, using monoclonal antibodies. The minimum criteria established by the International Society for Cell Therapy to ensure the identity of MSCs use CD73 and CD105 as positive markers and CD34, CD31, CD45 as a negative. Results. According to the results of histological, immunohistochemical, morphometric and statistical studies, it was found that in the biopsy of both tissues the relative number of cells with an immunoprofile CD105+, CD73+, CD34–, CD31–, CD45– in the standard field of view (×200) was: 7.25 (5.42; 8.89 ) %, and 11.11 (8.46; 13.45) %, no statistically significant difference was found between comparison groups (р &gt; 0,05). Conclusion. The therapeutic effect of mesenchymal stem cells of subcutaneous adipose tissue has been proven, thus the identification of similar cells in the biopsy material and relatively similar density in the Hoffa body makesit an important source of adipose-derived stem cells that can be used for regenerative engineering tissue.

Investigating the Influence of Varying Surface Conditions on Human Postural Control and Sensory Integration Strategies.

This study investigated the effects of different surface conditions on postural stability in response to unexpected perturbations. Thirty healthy adults underwent balance assessments on flat, incline ramp, balance pad, and balance pad on incline ramp surfaces. The center of pressure (COP) displacement in the mediolateral (ML) and anteroposterior (AP) directions, the velocity, and the area were measured. We found that the flat and ramp conditions resulted in significantly lower COP ML (F(3, 87) = 38.272, p < 0.001, ηp2 = 0.569) and AP displacements (F(3, 87) = 89.177, p < 0.001, ηp2 = 0.755), velocity (F(3, 87) = 89.177, p < 0.001, ηp2 = 0.755), and area (F(3, 87) = 52.659, p < 0.001, ηp2 = 0.645) compared to the balance pad and balance pad on ramp conditions (p < 0.05). The use of a balance pad, particularly on a ramp, significantly increased all the COP measurements, suggesting greater challenges to postural control. Through these findings, we demonstrate the adaptability and limitations of the human postural control system in response to varying surface conditions and perturbations.

Clostridium and Cryptosporidium outbreak linked to a splash pad

Background. Splash pads for recreational purposes are widespread. Using these pads can pose a health risk if they lack installation regulation and water quality supervision. Our aim was to describe a waterborne disease outbreak caused by Clostridium perfringens and Cryptosporidium spp. in a Barcelona district and the measures taken for its control.Methods. On August 2018, 71 cases of acute gastroenteritis were detected, affecting people who used a splash pad or were in contact with a user. Microbiological and environmental investigations were carried out. A descriptive analysis of the sample and Poisson regression models adjusted for age and sex were performed, obtaining frequencies, median values, and adjusted prevalence ratios with their 95% confidence intervals.ResultsThe median age of the cases was 6.7 years, 27 (38%) required medical care, and three (4.2%) were hospitalized. The greater the number of times a person entered the area, the greater the number of symptoms and their severity. Nineteen (76%) of the 25 stool samples collected from cases showed the presence of one or both pathogens. Environmental investigations showed deficiencies in the facilities and identified the presence of both species in the splash pad. Health education and hygiene measures were carried out, and 14 days after the closure of the facilities, no more cases related to the pad were recorded.Conclusions. Specific regulations are needed on the use of splash pads for recreational purposes. Until these regulations are in place, these types of facility should comply with the regulations that apply to swimming pools and spas, including those related to the design of the tanks, water recirculation systems, and adequate disinfection systems.

Self-powered noncontact triboelectric nanogenerators with microstructured square-loop surface and dielectric electron-blocking layer for far-distance motion perception and trajectory tracking

Continuous monitoring of indoor human activities is crucial for the healthcare of elder people or patients. The self-powered noncontact triboelectric nanogenerator (TENG) sensor has been recently developed as a promising noncontact sensing tool with many advantages, but its capability of detecting object motion in a far distance still remains inferior. Herein, by implementing multiple strategies of micro-structuring triboelectric surface, introducing dielectric layer, and using functional nano fillers, we develop a single-electrode-mode noncontact TENG sensor by constructing a triboelectric cobalt nanoporous carbon/Ecoflex nanocomposite layer with microstructured square-loop surface on top of a dielectric copper calcium titanate/Ecoflex nanocomposite layer with colossal permittivity. After in-depth optimization of the material selection, component composition and structure design, the developed sensor with effective electrode area of 6.25 cm2 can deliver a high output voltage of 29 V at 1 cm, and is capable of detecting motions at an extremely far distance of 6 m. Towards practical applications, the TENG unit for single-motion detection of mouth breathing, human walking, and basketball bouncing are demonstrated. Furthermore, multiple TENG units can be assembled into array to realize the complex trajectory tracking for the use of proximity touch pad, indoor human activity monitoring, and garage car parking. This work for the first time extends the TENG noncontact sensing capability to several meters, which is potential in the proximity motion detection and indoor activity monitoring.

Clinical Study on Low-Frequency Electrical Pulse Acupoint Stimulation Combined with Pelvic Floor Muscle Exercise in the Treatment of Urinary Incontinence after Radical Prostatectomy.

Urinary incontinence (UI) is a common complication after radical prostatectomy (RP). It has a great influence on the postoperative quality of life of patients. This study aims to explore the clinical efficacy of low-frequency electrical pulse acupoint stimulation combined with pelvic floor muscle exercise in the treatment of UI after RP. The clinical data of 129 patients with UI after receiving RP in our hospital from July 2020 to July 2023 were retrospectively analysed. A total of 65 patients who received pelvic floor muscle exercise from July 2020 to January 2022 were set as the reference group. Of these patients, four were excluded, resulting in the inclusion of 61 cases. A total of 64 patients who received low-frequency electrical pulse acupoint stimulation combined with pelvic floor muscle exercise from February 2022 to July 2023 were classified into the observation group. Of these patients, four were excluded, and 60 cases were finally included. SPSS 23.0 was used to analyse the use of urine pads, recovery time of urinary control and improvement of urination in the two groups. Before treatment, no significant difference existed in the use of urine pads, urination condition, maximum flow rate, maximum cystometric capacity, maximum urethral closure pressure, abdominal leak point pressure and scores on Short-Form-36 Health Survey (SF-36) in both groups (p > 0.05). After treatment, the observation group had significantly lower use of urinary pads, urination frequency and leakage times; Significantly shorter recovery time of urinary control (p < 0.05); And significantly higher maximum flow rate, maximum cystometric capacity, maximum urethral closure pressure, abdominal leak point pressure and SF-36 scores than the reference group (p < 0.05). The combination of low-frequency electrical pulse acupoint stimulation and pelvic floor muscle exercise can improve clinical symptoms, shorten the recovery time of urinary control and improve urodynamics and quality of life in patients with UI after RP.

Comparison of In-person Versus Online Comprehensive Pelvic Floor Rehabilitation Program Following Prostatectomy

ObjectiveTo compare continence outcomes in post-prostatectomy patients undergoing supervised in-person versus online pelvic floor muscle training and pelvic floor education (iPMFT versus oPFMT/PFE). Despite the proven benefit of in-person PFMT for urinary incontinence (UI) following prostatectomy, numerous barriers impede access. We developed a comprehensive online program to deliver oPFMT/PFE. MethodsWe performed a retrospective review of patients receiving iPFMT versus oPFMT/PFE with minimum 12-month follow-up. Outcomes were assessed at 3-weeks, 3-, 6-, and 12-months following robotic-assisted laparoscopic prostatectomy using validated ICIQ-MLUTS and IIQ-7 questionnaires and additional items (daily pad use (PPD) and satisfaction). The primary study outcome was ICIQ-MLUTS SUI domain score (SDS). Secondary outcomes were PPD, PPD cure (0 PPD at 12-months), SUI cure (12-month SDS = baseline score), and QOL score (IIQ-7 Sum). ResultsAnalysis included 41 men. Though men enrolled in oPFMT/PFE demonstrated lower SUI domain scores than iPFMT at most time points (3w p<0.01, 3m p=0.04, 6m p=0.15, 12m p=0.04), the rate of improvement from 3-weeks to other time points was similar between groups (p=NS at all time points)). SDS Cure was no different for oPFMT/PFE (75%, 15/20) compared to iPFMT (60%, 12/20, p=0.3). PPD and IIQ-7 were also similar at all time points and demonstrated a similar rate of decrease over time through 12 months. ConclusionsSignificant and similar improvements in UI and QOL are seen both in men completing iPFMT or oPFMT/PFE programs. Our novel online program provides another option to improve PFMT/PFE access in men undergoing RALP.